I have the greatest privilege of being associated with Native cultures of many continents.. thus satisfying my curiosity and desire to travel and the chance to help them with my medical expertise. these notes are from those travels. I am a professor at the University of Havana

mardi 7 mai 2013

PEER TO PEER HEALTH PROMOTION AT WORK PLACE : ZHENG HE'S METHOD OF COLLABORATION

Peer to
peer health promotion at work place

The humble boss of Bogor

An old Indian story talks
about a group of blind men coming across an elephant. Each of the blind men
touched a different part of the elephant and gave a description of what he believed
an elephant was. The first person touched the elephant’s trunk and claimed the
elephant to be a snake. The second person touched the elephant’s leg and
declared the elephant to be a tree trunk. Then the last person came forward,
touched the elephant’s ear and positively identified the elephant to be a sail.
Based on the blind men’s confined level of interaction with the elephant, their
observations made sense. However, if they had collaborated and holistically
studied the elephant, its true structure would have become apparent.
Understanding complex systems such as the human body can also benefit from the
same type of closely interactive collaboration. For many years, biologists have
been studying specific proteins and molecular pathways individually, describing
local interactions and perturbations in detail. Indeed, understanding the
individual components is an important first step, but, to truly understand
complex biological systems, an integrated approach must be taken

Leroy Hood, M.D., Ph.D.*

President, Institute for
Systems Biology, Seattle, WA, USA

Currently it seems that the
plethora of advices regarding Health seem to be led by men and men who are like
the blind men above. Body is divided into many parts, and the blind men/ women
in charge prescribe treatment, which usually involves either a western medicine
or a herbal/alternative medicine to "cure" that particular
dysfunction of that organ/ disease.

Very little attention is
being paid to the prevention of factors that cause disease, but lots of
information is available on how to treat a particular problem, of course for a
price, once again not the entire person, but their body component measurements:
blood pressure, blood sugar or cholesterol.

It is my strong belief that
in the future, medicine/ health counseling/ care would focus on the individual,
becoming proactive to prevent diseases rather than blind men/women waiting in
their offices to patch up what is failing in the body.

We would always need
doctors and other professionals for acute inflictions on our bodies, unforeseen
happenings in our bodies and mind dictated by our genes and bad luck, such as
accidents, both man made and natural.

But majority of suffering
is of chronic nature, and it is here that prevention is much better than a
cure!

Currently, obesity, heart
disease, diabetes, high blood pressure and preventable cancers kill more people
than any other cause. If you add to that depression, impotence, suicide, drug
tobacco and alcohol abuse, you would readily agree that prevention is the
key to a healthy life!

April 29,2013, published in
British medical Journal (On Line) (follows)

Men Who Are Obese While
Young Can Pay a Price Later

Danish study found
overweight males in their 20s had worse health in middle age

-- Men who are obese in
their early 20s have a significantly increased risk of dying or of having
serious health problems such as diabetes and heart disease by the time they
reach age 55, a new long-term study indicates.

Researchers tracked the
health of 6,500 Danish men from age 22 until age 55. At the start of the study,
83 percent of the young men had normal weight, 5 percent were underweight, 10
percent were overweight and 1.5 percent were obese.

By the end of the follow-up
period, nearly half of the men who were obese at age 22 had been diagnosed with
diabetes or high blood pressure, suffered a heart attack, stroke or blood clots
in the legs or lungs, or had died.

Compared to those with
normal weight, obese young men were eight times more likely to develop diabetes,
four times more likely to have a potentially fatal blood clot, and more than
twice as likely to develop high blood pressure, have had a heart attack or to
have died, according to the study published April 29 in the online journal BMJ
Open.

Every unit increase in body
mass index (a measure of body fat based on height and weight) was associated
with a 5 percent increased risk of heart attack, a 10 percent increased risk of
high blood pressure and blood clots, and a 20 percent increased risk of
diabetes.

Overall, obese young men
had a nearly 50 percent risk of developing any of these serious health problems
by middle age, compared with a 20 percent risk for young men with normal
weight, according to a journal news release.

So, we have so much to
gain, just by preventing Obesity and those Asians who are not exercising with a
BMI( weight in kg divided by height in meters squared, kg/m2) greater than
22-23, by decreasing their weight, they can prevent

DIABETES

HEART DISEASE

STROKE

I will describe here an example
of health promotion in a business setting, at a medium size business employing
150 people, in Bogor, Indonesia.

It is important to state
that the philosophical aspects are as important as the physical actions. Words
without actions mean very little and in the same way actions such as Running or
Jogging or Yoga means little if it has not philosophical background. Was it the
comedienne Joan Rivers who quipped: The first time I see a Jogger smiling, I
will consider it!

HP is an Indonesian, 52
years of age, has always been interested in a good lifestyle which incorporated
his philosophy of life, the fundamental of which can be summarized as Help
Others and Take care of others without expecting any reward.

He has a business of
supplying non ruminant animal feed to farms in the region and he travels a fair
bit for his business. He has six or
seven section managers and has collaborators in Malaysia, Cambodia, Thailand,
Italy, Sweden, Poland, Spain. He manages his time very well and is usually in
good communication with his friends near and far.

He spends time with his
family and children and one feels that it is a priority for him. His children
accompany him on many of his travels.

These following
observations are based on my repeated visits to Sentul/Bogor in Indonesia and
meeting him in various places in Asia: Phnom Penh, Bangkok, Kuala Lumpur,
Singapore and Europe: Paris and Amsterdam

On the days he is in town,
he arrives at the Sentul Lake at around 6 AM. Whoever wish to join him, from
his company , is welcome to do so.

On my recent visit to
Bogor, I could count up to 10 people, including most of his managers there in
the morning.

Up to one hour is spent, on
running, walking, jogging and stretching. There is always friendly banter and
joking and laughter.

We go back to the office of
the business which is situated just one km away and there we may have a fresh
Nespresso Coffee (he buys the capsules for this French coffee machine whenever
he is in Europe, the last time I was with him when he knew where to buy them in
Amsterdam)

Also he might order healthy
breakfast for all present from the restaurant attached called Gunung Mas which
he owns. One day we had Mee Hoon and it had a less fatty greasy taste than the one I had in Malacca.

During the hour together at
the Office there may be a fifteen minute session of Intense work out, modeled
after the Body Works. In my opinion there are Yoga asanas but done in quick
successions.

The managers have already
spent three hours before they turn their attention to their work.

Do you give the this time
off, so that they would be more productive, I asked.

No, I am already satisfied
with their work, but giving them this liberty of time to do exercise and spend
time socially, I am hoping that they would be happy and that their family would
be happy and the villages (suburbs) they live in would be cleaner and
healthier. More importantly they could share these stories with their workers.

There is a book published
in Singapore, with the title

Zheng He’s Art of
Collaboration. The sub title is : Understanding the Legendary Chinese Admiral
from a Management Perspective

The author is a vice dean of
the School of Business at the National University of Singapore.

He had analyzed the conduct
of the Admiral, who had at his disposal the largest fleet ever assembled by man
at that time, but he was humble and never intended to conquer any of the
kingdoms or sultanates he had visited but came on a mission of peace. It is
incredible that even after 600 years his legacy is well remembered for its non
colonial stand, its peaceful message and good ambassadorship.

When I was reading the
book, I realized that HP somehow manages his business much along the line
proposed by Zheng He. I will summarize some salient features of the Art of
Collaboration found in his treatises
over the long seven voyages he had for his Ming Emperor Employer..

COMMUNICATION

CAPACITY BUILDING

COORDINATION

CONTINUITY

I used the maxims of the
Great General and viewed at the Intentions and Behavior of HP towards his staff
and his managers and his friends.

Despite the enormous time
he spends with his managers, I have never once heard him discuss business with
them. He makes his purpose clear, that with continuing physical exercise and a
philosophical life style behind it, every one could achieve the health status
he has achieved.

I have told the staff that
we would consider HP’s measurements to be the Gold Standard to measures every
one else by

BP 98/68

Pulse of 62

He weighs the same as what
he did when left the university

I observed that his method
of communication was Motivational Interviewing, adjusting his advice to the
level needed to make changes. I would explain how he did it with me.

It was my second visit to
Sentul/Bogor in 2012 and at that time I had expressed an interest in joining
him in walking around the Sentul lake.

Fortunately
his shoe size and shorts were suitable to me, so he presented me with a pair of
Asics Shoes and a pair of shorts.

He advised me to think that
the walking is essential to my health.
You have to have a sensation of addiction to this daily procedure so that
wherever in the world you are, you would be finding out a place to do some
walking.

For the first three months,
don't run or jog, but walk at your pace.

After three months of doing
it as often daily as possible, you can increase the pace.

I was ready for the change
and was glad that I was not presented with a task of running or jogging like
others. It resonated with the Yogic
Philosophy of Patanjali: no undue exhaustion is to be experienced.

I could manage to walk
without feeling exhausted only 3 times around the lake. I.e. close to 2 km and
it took me more than 30 minutes .

Afterwards he was always
congratulatory about my feat and each day encouraged me to do the same.

When I left Sentul that
time, getting up to walk in the morning has become routine for me and wherever
I was, I was looking forward to doing it. When I am in a hotel or in a strange
town, I would also use the facilities in the hotel

By the time I returned for
further visits to Sentul, I was walking faster, I have definitely noticed changes in my body, in my breathing capacity
and my well being. In December, just four months after beginning of walking, I
was able to walk 10 times around the lake and on a recent visit, my walking
time has been halved since I began in August last year.

At all times he has been
encouraging me, and making sure that I have shorts, running shoes, socks and
tee shirts.

Now I always pack these
things when I travel since I have been able to walk in many parts of the world.
During winter in the northern hemisphere I was not able to do so .

COMMUNICATION

On each of
his emails he would remind me to keep on going and after the predicted three
months, it was no longer necessary. If I did not walk one particular day I
began missing it.

I have
noticed that among his managers, he has chosen them well so that each one
shines well in his chosen spot. The manager of the Travel Agency is well
travelled and is always available to organize trips for any of us. On my first visit, he organized a nice sight seeing tour
of Jogjakarta and Borobudur, yet on another occasion a trip to Semarang.

He has taken
particular efforts at CAPACITY BUILDING
such that the managers do their task without being asked to do it, and
he very rarely needs to exhort them to do it.

Because he is
the owner of the Business, he can coordinate the wellness activities. He is
able to give his managers and those workers who wish to participate up to three
hours to participate in wellness activities each day.

CO ORDINATION
and lastly

CONTINUITY

He is
personally is present each and every day while he is in town at the lakeside to
walk, run and jog and more importantly converse, joke and create the right sort
of atmosphere for every one to enjoy.

Does this
work? The Proof is in the pudding, as they say.

Collectively
the people who come to these gatherings regularly have lost over 100 kg. Every
one looses weight, first converting their fat into muscle and then loosing
weight after a persistence effort of months. So Don't do the exercises and
adopt this lifestyle with just the thought of loosing weight, but the objective
is to be healthy. People who were overweight or obese have lost the most, and
even those with normal body weight have trimmed themselves up

The results
of my own measurements.

Pak Joe has a
BP of 98/68 with a pulse of 62 which is our gold standard. Among the group only
one person has elevated BP but he is loosing weight and I expect the BP to
normalize.

No one has
Blood sugar levels in the diabetic or pre diabetic range.

This is a
gift of Pak Joe which is everlasting, more than any other material gift which
would be worn away by time.

In my own
case, I am grateful for the enthusiasm for taking care of myself which was
instilled on me on the shores of the Lake Sentul in Bogor In Indonesia.

As always, as
the great Admiral Zheng He had shown, when you have power and wealth; it is
masterful to be humble, shine out what is inside of you, and always think of
the welfare of other people rather than any hidden motives or agenda.

I must say,
HP from Bogor exemplifies many of the Admiral’s ways, 600 years later!

Qui êtes-vous ?

Ever since being a Medical Student and Trainee Doctor in Melbourne, London and Miami, I have been involved in Interantional Medicine . Currently I am associated with the excellent Peer to Peer Network for Diabetes care in Cambodia, Mo Po Tsyo, www.mopotsyo.org.
Also with the help of my good friends in Bogor, Indonesia we hope to do something similar but in a much smaller scale.
It is easy to tell you what I am: an Endocrinologist and a Medical Anthropologist, engaged in both fields.
Cuba, Miami and American Indians are the worlds that usually I rotate around. in the occident and Cambodia and Indonesia in the orient.

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Welcome to Cuba, Welcome to My World and Yours as well

Ever since I was a child, I have lived in two countries at a time and the countries changed: Brunei, Australia, Sweden, USA, England, Jamaica, various places in the USA..Now Cuba and USA with a definite commitment to the North American Indians (Los Indios)..

For a period, 2001-2014, there were numerous visits to Vietnam, Cambodia, Malaysia, Indonesia and Myanmar.Hope you enjoy reading my emotional outpourings, written on the road.. from a lover of Cuban Mind and Affections inside the island and the innocence of the Indigenous peoples..

We live with great expectation that the new rapprochement with the Govt of President Obama, will bring more changes, intellectual and cross cultural contacts and a broadening of the minds on both sides of the Straits.